Colitis (cont.)

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

What are the symptoms of colitis?

Inflammation of the colon causes the muscle layers to go into intermittent spasm and cause colicky or cramp-like pain that comes and goes. The pain usually is in the lower abdomen, but can be felt anywhere along the course of the colon. Since the muscles fail to contract in a normal pattern and the colonic contents move through the colon rapidly, there is little opportunity for water to be reabsorbed. This leads to watery diarrhea. If the lining of the colon becomes inflamed and breaks down, bleeding may occur. In ulcerative colitis, small ulcers form and are the cause of bleeding.

With colitis, particularly colitis involving the distal colon (rectum and sigmoid colon), the pain often crescendos and precedes a diarrheal bowel movement. After the bowel movement, the pain may subside but then returns with the next episode of diarrhea.

Depending upon the cause of the colitis, other organ systems in the body may be involved and produce symptoms. There may be fever, chills, malaise, fatigue,
and dehydration. Symptoms of dehydration include weakness, lightheadedness, and decreased urine output.

Ulcerative colitis is an autoimmune disease and may have associated symptoms outside of the colon. These can include joint swelling, eye inflammation (iritis),
canker sores in the mouth (aphthous ulcer), and skin inflammations (pyoderma gangrenosum).